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To the Applicant: This section is required and must be completed in the format provided. If incomplete, your application will not be
evaluated. The section is to be completed by a high school or college counselor or advisor, an instructor, or a work supervisor who knows
you well.
To the Adult Appraiser: You have been asked to provide information in support of this application. Please give immediate and serious
attention to the following statements. When complete, please return to applicant. If you prefer, photocopy this section and return to applicant
in a sealed envelope. A letter of recommendation does not replace this section.
The applicant’s choice of a postsecondary educational
program is
The applicant’s achievements reflect his/her ability
The applicant’s ability to set realistic and attainable goals is
The quality of the applicant’s commitment to school and/or
community is
The applicant is able to seek, find, and use learning resources
The applicant demonstrates curiosity and initiative
The applicant demonstrates good problem-solving skills, follows
through, and completes tasks
The applicant’s respect for self and others is
Comments:
Appraiser’s Name Title Telephone ( )
Signature Organization Date
A complete transcript of grades must be sent with this application. Grade reports are not acceptable.
1. Students currently or previously enrolled in college or vocational-technical school must include all college or vo-tech transcripts of
grades from each school attended. Online transcripts must display student name, school name, grade and credit hours earned for each
course, and term in which each course was taken. (Completion of high school information below is not necessary.)
2. High school seniors and students who have completed less than one full quarter or semester of postsecondary education must
include a high school transcript of grades and have this section completed by the appropriate school official. (A clear explanation of the
high school’s grading scale must also be submitted.)
Applicant ranks _______
in a class of __________
Cumulative Grade Point Average
Weighted: __________/4.0 scale
Unweighted: ________/4.0 scale
School Official’s
Signature Date Title Telephone ( )
School Official’s
Address: Street City State ZIP Code
The student is responsible for submitting all materials to Scholarship America on time. Incomplete applications will not be evaluated. This
application becomes complete and valid only when all of the following materials have been received:
Student Application with completed Applicant Appraisal
Current Complete Transcript(s) of Grades
(including grading scale)
Postmark deadline April 30
CERTIFICATION Scholarship America and the Beaumont Health selection committee has the sole responsibility for selecting recipients based on criteria as
set forth in the program’s description. This application becomes the property of Scholarship America. (It is recommended you keep a copy for
your files.)
I acknowledge decisions are final. I certify I meet eligibility requirements of the program as described in the guidelines and the
information provided is complete and accurate to the best of my knowledge. If requested, I will provide proof of information, including an
official transcript of grades. Falsification of information may result in termination of any award granted. I give Scholarship America
permission to release my application and supporting documents to Beaumont Health if I am selected as a finalist.
Applicant’s Signature Date
Parent’s Signature Date
BHNURSE PDF 2/17 Copyright
©
2017 Scholarship America All Rights Reserved
APPLICANT
APPRAISAL
(REQUIRED)
All materials, including transcript, must be addressed to:
The Phyllis E. Edwards Nursing Scholarship Award
Scholarship America
One Scholarship Way
Saint Peter, MN 56082
